scholarly journals Evaluating bronchodilator effects in chronic obstructive pulmonary disease using diffusion-weighted hyperpolarized helium-3 magnetic resonance imaging

2012 ◽  
Vol 112 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Miranda Kirby ◽  
Mohammadreza Heydarian ◽  
Andrew Wheatley ◽  
David G. McCormack ◽  
Grace Parraga
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Tissue Microstructure ◽  
Obstructive Pulmonary Disease ◽  
Time Points ◽  
Hyperpolarized Helium ◽  
Diffusion Weighted ◽  
Apparent Diffusion ◽  
Helium 3

The objective of this study was to evaluate the regional effects of bronchodilator administration in chronic obstructive pulmonary disease (COPD) using hyperpolarized helium-3 (3He) MRI apparent diffusion coefficient (ADC). Ten COPD ex-smokers provided written, informed consent and underwent diffusion-weighted, hyperpolarized 3He MRI, spirometry, and plethysmography before and 25 ± 2 min after bronchodilator administration. Pre- and postsalbutamol whole-lung (WL) ADC maps were generated and registered together to identify the lung regions containing the 3He signal at both time points, and mean ADC within those regions of interest (ROI) was determined for a measurement of previously ventilated ROI ADC (ADCP). Lung ROI with 3He signal at both time points was used as a binary mask on postsalbutamol WL ADC maps to obtain an ADC measurement for newly ventilated ROI (ADCN). Postsalbutamol, no significant differences were detected in WL ADC ( P = 0.516). There were no significant differences between ADCN and ADCP postsalbutamol ( P = 1.00), suggesting that the ADCN lung regions were not more emphysematous than the lung ROI participating in ventilation before bronchodilator administration. Postsalbutamol, a statistically significant decrease in ADCP ( P = 0.01) was detected, and there were significant differences between ADCP in the most anterior and most posterior image slices ( P = 0.02), suggesting a reduction in regional gas trapping following bronchodilator administration. Regional evaluation of tissue microstructure using hyperpolarized 3He MRI ADC provides insights into lung alterations that accompany improvements in regional 3He gas distribution after bronchodilator administration.

scholarly journals Diffusion-weighted hyperpolarized 129 Xe MRI in healthy volunteers and subjects with chronic obstructive pulmonary disease

2010 ◽  
Vol 65 (4) ◽  
pp. 1154-1165 ◽  
Author(s):  
S. Sivaram Kaushik ◽  
Zackary I. Cleveland ◽  
Gary P. Cofer ◽  
Gregory Metz ◽  
Denise Beaver ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Healthy Volunteers ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Weighted

scholarly journals Assessing the uptake, engagement, and safety of a self-management app, COPD.Pal®, for Chronic Obstructive Pulmonary Disease: a pilot study

2021 ◽  
Vol 11 (3) ◽  
pp. 557-562
Author(s):  
Liam Knox ◽  
Rachel Gemine ◽  
Sarah Rees ◽  
Sarah Bowen ◽  
Phil Groom ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pilot Study ◽  
Pulmonary Disease ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Time Points ◽  
Management Knowledge ◽  
Early Results ◽  
Feedback Questionnaire

AbstractChronic Obstructive Pulmonary Disease (COPD) is a widespread condition that accounts for 3 million deaths worldwide annually. Despite being extensive healthcare users, people with COPD (PwCOPD) only spend approximately 1% of their time with a healthcare professional. The rest of the time, they are encouraged to self-manage their condition. To encourage better self-management, Bond Digital Health have created a mobile phone app called COPD.Pal® that helps PwCOPD keep track of their condition. This pilot study aimed to assess the safety, engagement, and early efficacy of the app. 25 PwCOPD were recruited and given COPD.Pal® for 6-weeks. Healthcare usage, self-management knowledge, app engagement, dyspnoea, and health-related quality of life were measured at baseline and at 6-weeks. A feedback questionnaire was also collected at follow-up. T-tests investigated whether differences between the time points were evident in the data. No statistically significant differences were found between the time points for any of the variables measured. Average app engagement was 31.8 days with 84% using COPD.Pal® for 20 or more days during the 6-weeks. 89% of participants stated they would use the app regularly after the study, with 56% stating they’d use it long-term. This study determined that a digital, self-management app would be engaged with and early results indicate that the safety is non-inferior to standard care. Although self-management knowledge remained unaffected by app use, this study provided useful insights regarding how to improve this aspect. This represents one of few studies which involve end-users at an early stage of intervention development, an important strength of the research.

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